Friday, May 21, 2010

Of Romantic Rejection and Pain

Basha: Popoy, umuwi ka na!
Popoy: Mahal na mahal kita at ang sakit sakit na.
-- One More Chance (2007, Film)
Anyone who has loved and has been rejected can relate to Popoy’s pain. Some parting might be such a sweet sorrow, but according to Emily Dickenson, “parting is all we need to know of hell.”

I have heard stories from clients and friends about the pain of being romantically rejected—when your romantic advancement is refused by another or when an existing romantic relationship (real or perceived) is ended. Personally too, this is not foreign to me. I have been rejected—socially and romantically—a lot of times in my adult life.

So, I wondered what science has to say about this and to my surprise this has been studied!

Anyone who has experienced heartache knows that the “ache” is not symbolic but real. In fact, a study has shown that emotional pain like being romantically rejected affects the same primary brain regions as that of physical pain.

Nathan DeWall and his colleagues from University of Kentucky looked into fMRI scans of volunteers who experienced rejection. (Researchers manipulated a computer game so that some players feel excluded.) Results showed an interesting discovery. The brain region associated with physical pain lit up. Thus, the brain experienced emotional pain just as real as it would if the body had been wounded.

The researchers investigated further by asking if taking painkillers will also ease the emotional pain just as it will for physical pain. In a different study, volunteers were given 1000 milligram dose of acetaminophen—the active ingredient in Tylenol— every morning and night for three weeks while others took a placebo. Those who took the drug reported less emotional pain compared to those who did not. Thus, taking painkillers also relieves the emotional pain.

So if you are broken-hearted, take a Tylenol and it will ease the pain.

But we all know that coping with break-up or rejection is not that simple. Even the psychologists who did the study do not suggest popping Tylenol every time one feels broken-hearted. The drug taken frequently and in large doses has side effects on the liver.

Psychiatrists Thomas Lewis, Fari Amini, and Richard Iannon from the University of California in San Francisco think that when we are romantically rejected we undergo a psychobiological (as it also involves neurochemicals in the brain) process of two phases: protest phase and resignation/despair phase. Taking Tylenol makes that brain region associated with physical pain NOT light up but it will not allow one to skip the process.

During the protest phase, the abandoned lover will try everything to win their sweetheart back. We obsessively dissect all aspects of the relationship, establish what went wrong, and strategize on how to rekindle the romance. Helen Fisher, an anthropologist by profession but had studied romantic interpersonal attraction for more than 30 years, calls this frustration aggression–when the romantic love is spoiled, the lover just loves harder.

Another characteristic of protest is what Psychologist Reid Meloy calls abandonment rage. We know that sometimes it is easier to move on when we are angry with our ex-lovers. But, why do we hate someone we loved? “Perhaps because it enables jilted lovers to extricate themselves from dead end love affairs so that they can renew the vital courting process sooner,” Helen Fisher hypothesized.

Over time, we give up and we enter the stage of hopelessness, resignation, and despair. We cry, lie in bed, stare into space, drink, forget to take care of self and become ugly (inside and out). Elizabeth Gilbert—author of Eat, Pray, and Love—said that we know we have reached romantic rejection’s final destination when we have completely and mercilessly devaluated our self.

Some broken-hearted lovers are hopeful and resilient (and romantics!) that they are able to dust themselves off and redirect their energy to fall in love again. But some broken-hearted lovers suffer from clinical depression, die from heart attacks or strokes, or commit suicides.

I think these findings have school, work, or organizational implications. With mixture of pain, frustration aggression, rage, hopelessness, and despair one experience during romantic rejection, I advocate that organizations should excuse or set days for emotional sick leaves. Parents, teachers, siblings, friends, and bosses should take romantic rejections and heartaches seriously because we know and have experienced that unrequited love decreases concentration, energy, motivation, and performance.

If an employee gets sick, one gets a medical certificate from a medical doctor to prove that he or she was sick, and is also given a certificate of fitness to work. I propose that if an employee experiences romantic rejection (or any social rejection), one gets a certificate from a psychologist (like me) to ensure his or her mental health and psychological well-being.

So are you broken-hearted? Take a Tylenol and call me in the morning.
"How cruel, you say. But did I not warn you? Shall I count for you love's ways? Fear, jealousy, revenge -- pain. They all belong to love's innocent game."
These words from a Celtic legend Tristan and Iseult survived for centuries. Now, I agree that the only sure thing about loving is pain. But still I wonder, even if it is painful-- when love goes wrong -- people work, write, sing, dance, travel overseas (wink here), sacrifice, kill, and die for love. Romeo Montague of Verona was right,
"Is love a tender thing? It is too rough, too rude, too boisterous, and it pricks like thorn."

Sunday, May 2, 2010

The Joy of Being a Counseling Psychologist

Ruel (not his real name) is a 12 year old boy who was referred to me for therapy a few months ago. He is quiet, shy, and slow to warm up kid. When you ask him a question, he answers by saying one or two words or by moving his shoulders up and down, then, he continues with whatever he is doing.

Unlike my other clients who are willing to tell stories about themselves, Ruel is very private. Thus, one of my biggest hurdle with Ruel is to build rapport and trust between me and him.

There were sessions we did play and expressive arts therapy. But, I think I hit a jackpot in rapport building when he taught me how to make a crane and a tulip origami.

That afternoon, I took some scratch papers and coloring pens and I asked him to draw. But, he did not finish his drawing, instead, he started folding the papers. At first, I was just quiet and I observed (hoping that I can get a glimpse of his personality). But as soon as I realized he was making a paper crane, right there and then, I asked him to teach me.

And gladly, he did. Step by step, I followed the way he folded the paper. Sometimes, I asked him to slow down and I also questioned the steps if I was confused.
I was an excited student because I was dying to learn how to make a paper crane since I saw Prison Break. =) But in the end, I learned to make a paper crane and a tulip!

You see, Ruel was referred to me for specific reasons. And sometimes, it is frustrating because, at that time, we were faaaar from discussing what he was referred to me for.

I do make plans before I meet up with him, but, these plans are usually not followed. There are times that when he goes inside the room, I just allow him to do what he wants to do. Sometimes, I feel embarrassed to the supporting organization because I think I might not be able to give a concrete behavioral report of his progress.

But, if you read my therapy progress reports, I have a good sense of his phenomenology, I have hypotheses for it, and I have recommendations too. But you see, sometimes, we want results right away, and results mean changes in behavior/s Ruel was referred too.

There was one session before we were about to break for Christmas. With papers and pen in front of him, Ruel started writing letters. And I consider this as a breakthrough!

Letters are perfect data of what is happening in his phenomenology! Plus, I was so happy as he opened himself through these short letters.

I was feeling creative too that I asked him a favor. I asked him to write another letter. This time, the letter should be addressed to me. I told him that I will also write a letter addressed to him. My hidden agenda for that moment was to fish for his ideas of me and these therapy sessions.

When we were both finished writing our letters. I read aloud my letter to him.

Dear Ruel,
I really really want to know you more. And part of it is for you to tell me stories about yourself. But do not to be afraid to tell your stories to me. Only tell what you are comfortable in sharing. But always remember that I will be here for you whatever these stories are.

Also, our next meeting will be a month from now since I will go home to Cebu for the holidays. Be good when I am away. Merry Christmas and a happy new year, Ruel.

Ruel was to shy to read aloud his letter to me. So I read it quietly. I am editing some parts for confidentiality but one line in his letter paid off my long travels from Philcoa, Quezon City to La Paz, Makati City every Tuesday:

Dear Nil…

…marami salamat sa sayo dahil ako ay nag iba para sayo.

Ruel (and he drew two faces, one he labeled as me and the other him.)
I was so surprised! Whoah, wait?!?! What did I do? I thought I might not have done anything concrete, but somehow my presence affected him. If I did not see Ruel writing the whole note in front of me, I would have thought someone else had written it.

Carl Rogers would have been so proud of me and I am happy and proud of myself too. =) This is the reward of what I do. This is the joy of being a counseling psychologist.